tbuckley/cabot-search huggingface dataset:
Opioid Dose Trajectories and Associations With Mortality, Opioid Use Disorder, Continued Opioid Therapy, and Health Plan Disenrollment
Authors: Ingrid A. Binswanger, Susan M. Shetterly, Stanley Xu, Komal J. Narwaney, David L. McClure, Deborah J. Rinehart, Anh P. Nguyen, Jason M. Glanz
Journal: JAMA Network Open (2022)

Importance Uncertainty remains about the longer-term benefits and harms of different opioid management strategies, such as tapering and dose escalation. For instance, opioid tapering could help patients reduce opioid exposure to prevent opioid use disorder, but patients may also seek care elsewhere and engage in nonprescribed opioid use. Objective To evaluate the association between opioid dose trajectories observed in practice and patient outcomes. Design, Setting, and Participants This retrospective cohort study was conducted in 3 health systems in Colorado and Wisconsin. The study population included patients receiving long-term opioid therapy between 50 and 200 morphine milligram equivalents between August 1, 2014, and July 31, 2017. Follow-up ended on December 31, 2019. Data were analyzed from January 2020 to August 2022. Exposures Group-based trajectory modeling identified 5 dosing trajectories over 1 year: 1 decreasing, 1 high-dose increasing, and 3 stable. Main Outcomes and Measures Primary outcomes assessed after the trajectory period were 1-year all-cause mortality, incident opioid use disorder, continued opioid therapy at 1 year, and health plan disenrollment. Associations were tested using Cox proportional hazards regression and log-binomial models, adjusting for baseline covariates. Results A total of 3913 patients (mean [SD] age, 59.2 [14.4] years; 2767 White non-Hispanic [70.7%]; 2237 female patients [57.2%]) were included in the study. Compared with stable trajectories, the decreasing dose trajectory was negatively associated with opioid use disorder (adjusted hazard ratio [aHR], 0.40; 95% CI, 0.29-0.55) and continued opioid therapy (site 1: adjusted relative risk [aRR], 0.39; 95% CI, 0.34-0.44), but was positively associated with health plan disenrollment (aHR, 1.66; 95% CI, 1.24-2.22). The decreasing trajectory was not associated with mortality (aHR, 1.28; 95% CI, 0.87-1.86). In contrast, the high-dose increasing trajectory was positively associated with mortality (aHR, 2.19; 95% CI, 1.44-3.32) and opioid use disorder (aHR, 1.81; 95% CI, 1.39-2.37) but was not associated with disenrollment (aHR, 0.90; 95% CI, 0.56-1.42) or continued opioid therapy (site 1: aRR, 0.98; 95% CI, 0.94-1.03). Conclusions and Relevance In this cohort study, decreasing opioid dose was associated with reduced risk of opioid use disorder and continued opioid therapy but increased risk of disenrollment compared with stable dosing, whereas the high-dose increasing trajectory was associated with an increased risk of mortality and opioid use disorder. These findings can inform opioid management decision-making.
White House Advisor Nahid Bhadelia, MD, MALD, on COVID-19 in Resource-Limited Nations—Undercounted Deaths, Vaccine Inequity, and More
Authors: Jennifer Abbasi
Journal: JAMA (2022)

This Medical News article is an interview with Nahid Bhadelia, MD, MALD, the White House COVID-19 Response Team’s senior policy advisor for Global COVID Response.
Coding Error for the Sex Variable in a Meta-analysis
Authors: Eirini Karyotaki
Journal: JAMA Psychiatry (2022)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Psychiatry HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Psychiatry journal
Error in Coding of Sex Variable in Text and Tables
Authors: Eirini Karyotaki
Journal: JAMA Psychiatry (2022)

Eirini Karyotaki, PhD; Ricardo Araya, MD, PhD; Ronald C. Kessler, PhD; Ahmed Waqas, MD, PhD; Arvin Bhana, PhD; Atif Rahman, PhD; Camila T. Matsuzaka, MD; Clara Miguel, MSc; Crick Lund, PhD; Emily C. Garman, PhD; Etheldreda Nakimuli-Mpungu, PhD; Inge Petersen, PhD; John A. Naslund, PhD; Marguerite Schneider, PhD; Siham Sikander, PhD; Mark J. D. Jordans, PhD; Melanie Abas, MD, PhD; Pauline Slade, PhD; Stephen Walters, PhD; Traolach S. Brugha, MD; Toshi A. Furukawa, MD, PhD; Yagmur Amanvermez, MSc; Marcelo F. Mello, MD, PhD; Milton L. Wainberg, MD, PhD; Pim Cuijpers, PhD; Vikram Patel, MD, PhD
Jane (or Dr Doe?) Will Reply to Your Patient Portal Message Now
Authors: Lekshmi Santhosh, Leah Witt
Journal: JAMA Network Open (2022)

In this issue of JAMA Network Open, Harvey and colleagues 1 analyzed more than 90 000 electronic messages sent to physicians by more than 34 000 patients and found that women physicians, doctor of osteopathic medicine (DO) physicians, and primary care physicians (PCPs) were more frequently addressed by first name instead of formal professional title.The authors found that women had greater than twice the odds as men to be addressed by their first name, even after adjusting for patient gender, physician age, degree, trainee vs faculty member, and specialty.DO physicians and PCPs were also more likely to be addressed by their first name, but to a lesser degree than women physicians were.Untitling (or uncredentialing) is a phenomenon in which an individual's formal title is omitted in a professional context and is a subtle but important form of unconscious bias. 2 It is a phenomenon
Distribution of High-Sensitivity Cardiac Troponin and N-Terminal Pro–Brain Natriuretic Peptide in Healthy Transgender People
Authors: Dina N. Greene, Robert L. Schmidt, Robert H. Christenson, Jessica Rongitsch, Katherine L. Imborek, Heather Rebuck, Thomas S. Lorey, Amy K. Saenger, Matthew D. Krasowski
Journal: JAMA Cardiology (2022)

Sex-specific differences in the commonly used cardiac biomarkers high-sensitivity cardiac troponin (hs-cTn) and N-terminal pro-brain natriuretic peptide (NT-proBNP) are apparent. There is an absence of medical literature delineating the concentration differences for these biomarkers in transgender individuals without cardiac disease.To determine the distribution of hs-cTn and NT-proBNP in healthy transgender people.In this cross-sectional prospective study, healthy transgender individuals prescribed testosterone or estradiol for 12 months or more were recruited from internal medicine and primary care clinics that specialize in transgender medical care between November 1, 2017, and July 1, 2018.Testosterone or estradiol for 12 months.Concentrations for hs-cTnI (troponin I), hs-cTnT (troponin T), and NT-proBNP were measured.Transgender people prescribed testosterone (n = 79; mean [SD] age, 28.8 [7.8] years) or estrogen (n = 93; mean [SD] age, 35.1 [11.7] years) were recruited. The concentration of hs-cTn was significantly higher in transgender men relative to transgender women. For Abbott hs-cTnI levels, the median (IQR) concentration observed in transgender men and women was 0.9 (0.6-1.7) ng/L and 0.6 (0.3-1.0) ng/L, respectively. Results were similar across 2 additional hs-cTn assays. In contrast, NT-proBNP level was higher in transgender women. The median (IQR) NT-proBNP concentration was significantly higher in transgender women ( 49 [32-86] ng/L) than in transgender men (17 [13-27] ng/L).Findings of this cross-sectional study suggest that the differences in concentration for hs-cTn and NT-proBNP between transgender men and women were similar to what is observed between cisgender men and women. Sex hormones, rather than sex assigned at birth, may be a stronger driver of the observed concentration differences between healthy men and women for biomarkers of cardiac disease.
Reevaluating Liver Donor Risk in the Era of Improved Hepatitis C Virus Treatment
Authors: Thomas J. Handley, Katherine Arnow, Kazunari Sasaki, Allison Kwong, Marc L. Melcher
Journal: JAMA Surgery (2022)

This cohort study examines the risk of graft failure associated with donors with hepatitis C virus (HCV) infection before and after the introduction of direct-acting antiviral medications.
Benefit of Implantable Cardioverter-Defibrillators in Patients With Catecholaminergic Polymorphic Ventricular Tachycardia—Reply
Authors: Silvia G. Priori, Andrea Mazzanti
Journal: JAMA Cardiology (2022)

In Reply We thank Maass and Cox for their comment on our work,1 and for stimulating the discussion on the role of implantable cardioverter-defibrillators (ICDs) in patients with catecholaminergic polymorphic ventricular tachycardia (CPVT).
Implementation of a Geriatric Trauma Clinical Pathway
Authors: Evan G. Pivalizza, Sudipta Sen, Nadia Hernandez
Journal: JAMA Surgery (2022)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Surgery HomeNew OnlineCurrent IssueFor Authors Podcast Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Surgery journal
Use of Euphemisms to Avoid Saying <i>Death</i> and <i>Dying</i> in Critical Care Conversations—A Thorn by Any Other Name
Authors: Michael B. Pitt, Marissa A. Hendrickson, Jordan Marmet
Journal: JAMA Network Open (2022)

Margaret H. Barlet, BA; Mary C. Barks, MA; Peter A. Ubel, MD; J. Kelly Davis, BA; Kathryn I. Pollak, PhD; Erica C. Kaye, MD; Kevin P. Weinfurt, PhD; Monica E. Lemmon, MD
Lifetime Sunburn Trajectories and Associated Risks of Cutaneous Melanoma and Squamous Cell Carcinoma Among a Cohort of Norwegian Women
Authors: Simon Lergenmuller, Corina S. Rueegg, Flavie Perrier, Trude E. Robsahm, Adele C. Green, Eiliv Lund, Reza Ghiasvand, Marit B. Veierød
Journal: JAMA Dermatology (2022)

To our knowledge, no study has prospectively investigated sunburn patterns over age periods from childhood to adulthood and their associations with skin cancer risk.To identify lifetime trajectories of sunburns and compare the association between these trajectories and subsequent risk of cutaneous melanoma and squamous cell carcinoma (cSCC).This population-based cohort study included participants from the Norwegian Women and Cancer Study, established in 1991, with follow-up through 2018. Baseline questionnaires were issued from 1991 to 2007, with follow-up questionnaires every 5 to 7 years. Data analysis was performed from March 16, 2021, to December 4, 2021.Participants reported pigmentation factors, sunbathing vacations, and indoor tanning. Annual frequencies of sunburns were reported for childhood, adolescence, and adulthood.Information on cancer diagnoses, emigration, and death were obtained through linkage to the Cancer Registry of Norway using the unique personal identification number of Norwegian citizens.Of the 172 472 women (age range, 31-70 years) who returned questionnaires, 169 768 received questions about sunburns at study inclusion. Five classes (stable low, low-moderate-low, low to high, high to low, and stable high) of individual lifetime sunburn trajectories with similar shapes were estimated in 3 samples up to 39 years (n = 159 773), up to 49 years (n = 153 297), and up to 59 years (n = 119 170). Mean follow-up ranged from 14.3 to 19.5 years in the 3 samples, during which 1252 to 1774 women were diagnosed with incident primary melanoma and 739 to 871 women with incident primary cSCC. With hazard ratios (HRs) and 95% CIs estimated using a Cox proportional hazards model, the stable high and high to low trajectories showed statistically significant increased melanoma and cSCC risks compared with the stable low trajectory across all samples (≤39 years for stable high and high to low trajectories: melanoma: HR, 1.50 [95% CI, 1.28-1.75] and HR, 1.44 [95% CI, 1.20-1.73]; cSCC: HR, 1.51 [95% CI, 1.22-1.87] and HR, 1.47 [95% CI, 1.14-1.91]). Other trajectories showed increased risk, though generally weaker and mainly estimates that were not statistically significant. There was no statistically significant heterogeneity between melanoma and cSCC estimates.This cohort study showed that high sunburn frequency throughout life was associated with increased melanoma and cSCC risk. Furthermore, sunburns in childhood are especially important for subsequent risk of these skin cancers. Avoiding sunburns throughout life, in particular in childhood, is therefore crucial.
Benefit of Implantable Cardioverter-Defibrillators in Patients With Catecholaminergic Polymorphic Ventricular Tachycardia
Authors: Alexander H. Maass, Moniek G. P. J. Cox
Journal: JAMA Cardiology (2022)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Cardiology HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Cardiology journal
Gene and cell therapies in China: booming landscape under dual-track regulation
Authors: Chen Yin, Jianchao Gao, Guanqiao Li, Hongxi Hu, Liyun Zhou, Shuang Lu, Xiaoyuan Chen
Journal: Journal of Hematology & Oncology (2022)

The booming of gene and cell therapy (GCT) worldwide in recent years has been observed, especially in the field of cancers. In order to provide the comprehensive GCT landscape in China with a focus on differential development pathways under the current dual-track regulation mode, we analyzed 953 clinical trials initiated by March 2021 including Investigational New Drugs (IND) registered trials and investigator-initiated trials (IITs). We classified GCT products into three categories and analyzed the clinical development by phases and regulation tracks, disease areas, indications, and targets. We found that CAR-T therapies from ex vivo category and stem and somatic cells from non-gene category are two most studied therapy types and GCT mostly focused on cancers. The number of IITs far exceeded IND-registered trials except for in vivo category. After 2017, when the cell therapy guideline issued, products of all categories boomed, especially the ex vivo categories. These data showed that current dual regulation tracks in China complemented each other and together facilitated the GCT development, especially after 2017. More consistent technical standards and risk-based regulation will help bring more GCT products to patients.
A Small Molecule Reacts with the p53 Somatic Mutant Y220C to Rescue Wild-type Thermal Stability
Authors: Keelan Z. Guiley, Kevan M. Shokat
Journal: Cancer Discovery (2022)

The transcription factor and tumor suppressor protein p53 is the most frequently mutated and inactivated gene in cancer. Mutations in p53 result in deregulated cell proliferation and genomic instability, both hallmarks of cancer. There are currently no therapies available that directly target mutant p53 to rescue wild-type function. In this study, we identify covalent compsounds that selectively react with the p53 somatic mutant cysteine Y220C and restore wild-type thermal stability. The tumor suppressor p53 is the most mutated gene in cancer, and yet no therapeutics to date directly target the mutated protein to rescue wild-type function. In this study, we identify the first allele-specific compound that selectively reacts with the cysteine p53 Y220C to rescue wild-type thermal stability and gene activation. See related commentary by Lane and Verma, p. 14. This article is highlighted in the In This Issue feature, p. 1.
Implementation of a Geriatric Trauma Clinical Pathway
Authors: Binghao Zhao, Hao Xing, Wenbin Ma
Journal: JAMA Surgery (2022)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Surgery HomeNew OnlineCurrent IssueFor Authors Podcast Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Surgery journal
Association Between Buprenorphine Treatment Gaps, Opioid Overdose, and Health Care Spending in US Medicare Beneficiaries With Opioid Use Disorder
Authors: Jason B. Gibbons, Jeffrey S. McCullough, Kara Zivin, Zach Y. Brown, Edward C. Norton
Journal: JAMA Psychiatry (2022)

Importance Nonadherence to buprenorphine may increase patient risk of opioid overdose and increase health care spending. Quantifying the impacts of nonadherence can help inform clinician practice and policy. Objective To estimate the association between buprenorphine treatment gaps, opioid overdose, and health care spending. Design, Setting, and Participants This longitudinal case-control study compared patient opioid overdose and health care spending in buprenorphine-treated months with treatment gap months. Individuals who were US Medicare fee-for-service beneficiaries diagnosed with opioid use disorder who received at least 1 two-week period of continuous buprenorphine treatment between 2010 and 2017 were included. Analysis took place between January 2010 and December 2017. Interventions A gap in buprenorphine treatment in a month lasting more than 15 consecutive days. Main Outcomes and Measures Opioid overdose and total, medical, and drug spending (combined patient out-of-pocket and Medicare spending). Results Of 34 505 Medicare beneficiaries (17 927 [520%] male; 16 578 [48.1%] female; mean [SD] age, 49.5 [12.7] years; 168 [0.5%] Asian; 2949 [8.5%] Black; 2089 [6.0%] Hispanic; 266 [0.8%] Native American; 28 525 [82.7%] White; 508 [1.5%] other race), 11 524 beneficiaries (33.4%) experienced 1 or more buprenorphine treatment gaps. Treatment gap beneficiaries, compared with nontreatment gap beneficiaries, were more likely to be younger, be male, have a disability, and be Medicaid dual-eligible while less likely to be White, close to a buprenorphine prescriber, and treated with buprenorphine monotherapy (ie, buprenorphine hydrochloride). Beneficiaries were 2.89 (95% CI, 2.20-3.79) times more likely to experience an opioid overdose during buprenorphine treatment gap months compared with treated months. During treatment gap months, spending was $196.41 (95% CI, $110.53-$282.30) more than in treated months. Patients who continued to take buprenorphine dosages of greater than 8 mg/d and 16 mg/d were 2.61 and 2.84 times more likely to overdose in a treatment gap month, respectively, while patients taking buprenorphine dosages of 8 mg/d or less were 3.62 times more likely to overdose in a treatment gap month (maintenance of &amp;amp;gt;16 mg/d: hazard ratio (HR), 2.64 [95% CI, 1.80-3.87]; maintenance of &amp;amp;gt;8 mg/d: HR, 2.84 [95% CI, 2.13-3.78]; maintenance of ≤8 mg/d: HR, 3.62 [95% CI, 1.54-8.50]). Buprenorphine monotherapy was associated with greater risk of overdose and higher spending during treatment gaps months than buprenorphine/naloxone. Conclusions and Relevance Medicare patients treated with buprenorphine between 2010 and 2017 had a lower associated opioid overdose risk and spending during treatment months than treatment gap months.
Generalized Nodules in an Older Adult Man
Authors: Jiang-Wei Cheng, Ling-Xi Liu, Jiu-Hong Li
Journal: JAMA Dermatology (2022)

A man in his 60s presented with an 8-month history of pruritic papulonodular lesions on his extremities and trunk, with no significant improvement with steroids and antihistamines. What is your diagnosis?
CUL3/SPOP complex prevents immune escape and enhances chemotherapy sensitivity of ovarian cancer cells through degradation of PD-L1 protein
Authors: Min Dong, Min Qian, Zhengyi Ruan
Journal: Journal for ImmunoTherapy of Cancer (2022)

Cancer immune escape is a main obstacle in designing effective anticancer therapeutic approaches. Our work was aimed to explore the function of cullin 3 (CUL3) in ovarian cancer cell immune escape and chemosensitivity.